Anatom3DIntrahepatic cholestasis of pregnancy
Cholestasis intrahepatica gravidarum · Intrahepatální cholestáza v těhotenství
female only
What it is
Bile acids build up in the mother's blood in late pregnancy and cause intense itching; about 1 in 150 pregnancies in the UK, more in South America and South Asia. Stillbirth risk rises clearly only when bile acids reach 100 µmol/L.
Symptoms & signs
- Itching of palms and soles, worse at night
- no rash, only scratch marks
- dark urine, pale stools
- mild jaundice (rare)
- preterm birth
🚩 Get help if…
- call 112 / 911 now Baby moving less, or a change in the pattern of movements
- see a doctor soon Itching of palms and soles without a rash
- see a doctor soon Yellow skin or eyes, dark urine or pale stools
- see a doctor soon Itch getting worse despite treatment
Where it strikes
Medical treatment
- Bile-acid and liver tests, repeated
- Ursodeoxycholic acid — PITCHES trial: no fewer stillbirths, preterm births or neonatal admissions; itch eased only slightly not confirmed in trials
- antihistamines to help sleep
- birth at 35–36 weeks if bile acids ≥100 µmol/L, 38–39 weeks if 40–99
- liver tests again after birth — it clears within weeks and often recurs in the next pregnancy
Natural & lifestyle
- Cool showers, loose cotton clothes
- emollients with menthol
Emerging & experimental
- Rifampicin for severe itch — in trials
- bile-acid transport inhibitors — early research
Alternative, off-label & anecdotal
Approaches used outside the guidelines, with what their supporters report and what testing has found so far.
- S-adenosylmethionine — small trials; weaker than ursodeoxycholic acid early / small studies
- Milk thistle and dandelion 'liver cleanses' — untested in pregnancy anecdotal / traditional
ICD codes
- ICD-10 O26.6
- ICD-11 JA65.0 Liver disorders in pregnancy, childbirth or the puerperium